Bill Richardson on Medicaid Block Grant Proposals

See his op-ed in today's Washington Post. He opposes a federal block grant to states; instead, he proposes a kind of inside-out block grant, in which the federal government limits what states can spend and guarantees to pay the rest of the cost of covering the people and services the state has chosen to cover. This doesn't strike me as the best policy idea (leaves the federal government at the mercy of the coverage decisions of states who aren't paying the bills, which creates all sorts of bad incentives), but it is a useful exercise to try to think of alternative Medicaid structures.